Relapse Prevention Through Naltrexone

relapseAddiction is extremely hard to recover from, but it is worth the effort if you are willing to take certain steps to improve your quality of life. It could be argued that there has been no other time in American history when addiction recovery has been more vital, in the wake of a prescription opioid and heroin epidemic. One of the reasons that the epidemic has continued as long as it has is the fact that recovering from opioid addiction is arduous and relapse rates are staggering.

There has been a lot of talk in the news recently about improving and expanding addiction treatment services nationwide, especially in rural America. Additionally, substance use disorder centers need to utilize evidence based treatments in order to mitigate the chances of relapse. A number of treatment centers have begun prescribing patients naltrexone – sold under the brand name Vivitrol ®.

Relapse Prevention

Early recovery can be a trying time, filled with strong cravings to use, coupled with new feelings and emotions that can drive such urges. New research suggests that utilizing naltrexone can dramatically reduce the chance of relapse, HealthDay reports. The study appears in the New England Journal of Medicine.

Naltrexone blocks the euphoric effects of opioid narcotics, which means if an addict were to use oxycodone or heroin they would not experience a high. The participants in the study were all opioid-addicted adults with history involving the criminal justice system. The participants were split into two groups, one receiving monthly naltrexone injections; the other group didn’t receive the drug but was referred to counseling and referrals to community treatment programs, according to the article.

After six months, only 43 percent of the Vivitrol group had experienced a relapse, compared with 64 percent in the other group. What’s more, no one in the naltrexone group had an overdose during the six months, compared to five overdoses in the group that did not receive the drug.

Promising Findings

“We believe our study is the first of its kind to look at the real-world effectiveness of extended-release naltrexone in community settings,” lead author at NYU Langone Medical Center in New York said in a news release. “It may be particularly effective with populations, such as recently released prisoners, who typically don’t have access to other evidence-based daily medications for opiate disorders, like methadone or buprenorphine.”

If you are in need of addiction treatment services, please contact Next Step Intervention. We can help you determine the best course of action for a successful recovery, giving you the tools necessary to prevent relapse.

Meditation Dramatically Reduced Patient Pain

meditationChronic pain affects millions of Americans. Left untreated, one’s quality of life can be severely diminished. In the United States, doctors treating chronic pain almost always turn to prescription opioids for pain management. While there is little question as to whether drugs like oxycodone are effective, the price of pain relief often leads to dependence, addiction and overdose.

The United States has been in the grips of an opioid epidemic for over a decade, a crisis driven primarily by prescription opioids. Government crackdowns and the tightening of prescribing restrictions have resulted in a number of prescription painkiller addicts turning to heroin to fill the gap. Heroin is cheaper and stronger than the majority of prescription opioids, and arguably more deadly for the fact that users are not always aware of what they are using.

Pain Management Alternatives

It may be harder to acquire opioid medications, but that does not mean that they are not being prescribed at alarming rates – still contributing to the problem. It is crucial that pain management experts turn to alternative forms of treatment, methods that do not involve dangerous narcotics.

New research suggests that meditation may be an effective alternative to opioids for treating pain, Medical Daily reports. A research team from Wake Forest Baptist Medical Center found that meditation dramatically reduced patient pain, without the assistance of their body’s “pain-blocking process and opioid receptors.” The research was published in The Journal of Neuroscience.

Meditation On Pain

The study involved 78 volunteers who were injected with either a saline placebo solution or naloxone, according to the article. The participants were separated in four groups; each group had a different variation of treatment, such as:

  • The first group received naloxone and meditated.
  • The second practiced meditation without naloxone.
  • The third group meditated and had a saline placebo.
  • The fourth group received the placebo and didn’t meditate.

The volunteers in the meditation groups saw pain reductions by over 20 percent, the article reports. However, the participants who did not meditate saw an increase in pain.

“Our finding was surprising and could be important for the millions of chronic pain sufferers who are seeking a fast-acting, non-opiate-based therapy to alleviate their pain,” said Dr. Fadel Zeidan, assistant professor of neurobiology and anatomy at Wake Forest Baptist Medical Center, in a statement. “Our team has demonstrated across four separate studies that meditation, after a short training period, can reduce experimentally induced pain. And now this study shows that meditation doesn’t work through the body’s opioid system.”

About Holistic Treatment

We, too, understand the importance of using a holistic treatment approach which includes meditation. Prayer or relaxation exercises are proven to lower anxiety and reduce tension by increasing an individual’s spiritual awareness and sense of wellbeing. When volatile emotions are managed, there is less chance of relapse or binging. Over time, a meditation practice can be a long-term tool for achieving and maintaining sobriety and finding joy in life.

The Comprehensive Addiction and Recovery Act (CARA)

addictionAddiction treatment and prevention are crucial if we are ever to get a handle on the prescription opioid and heroin epidemic in the United States. As presidential candidates criss-cross the country, addiction is a major talking point – especially in some of the most rural areas. Everyone is interested in learning how the potential leaders will tackle the problem, a crisis that is stealing 78 lives every day, according to the Centers for Disease Control and Prevention (CDC).

On top of an interagency effort to curb overprescribing, expand access to the life saving drug naloxone and create more substance use disorder treatment facilities Senators have been working to pass the Comprehensive Addiction and Recovery Act.

A Fighting Chance

The Comprehensive Addiction and Recovery Act (CARA), if passed, the bill authorizes the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use. After concerns that there would not be enough funding for the bill to be effective, an amendment to the bill was put forward for an additional $600 million in funding. On Wednesday, the amendment failed to receive the 60 votes needed to approve the additional funds, The Washington Post reports. Despite the amendment being voted down, Senate Democrats said they will not block the legislation over funding.

“There certainly is no desire to take the bill down over that through the caucus at large,” said Sen. Sheldon Whitehouse (D-R.I.), an author of legislation. “If somebody’s so mad about that that they just can’t bring themselves to vote for it, that will be their personal decision.”

The Big Picture

The democratic Senators choice to not block the bill because of the vote on Wednesday is indicative of how much attention the crisis deserves. While the amendment had the support of Senators from both sides of the aisle, there are a number of republicans who feel that the bill had enough funding to adequately address the opioid epidemic, according to the article. One could argue that some lawmakers do not fully grasp the true scope of the problem.

“It just seems ill-advised, to say the least, to appropriate more money when in fact there’s already $571 million available to deal with this epidemic,” said Senate Majority Whip John Cornyn (R-Texas).

This is a story we will continue to follow.

Needle Exchanges Have Funding On The Way

needle exchangeIt is fair to say that people are going to continue to use both prescription opioids and heroin despite the recent interagency actions of the Federal government which are doing what they can to assist states that are struggling to address the crisis. Of late, there have been three areas that have been the focus topics, some of which are controversial.

In a number of states, opioid addicts and their loved ones can acquire the life saving drug naloxone without a prescription. The drug, if administered in a timely manner, can reverse the deadly symptoms of an opioid overdose. There have also been reports of opioid addicts having to wait lengthy periods for a bed at substance use disorder treatment facilities, which is why the White House is calling upon Congress for $1.1 billion to expand access to treatment throughout the country.

Arguably, needle exchange programs remain to be controversial, despite the fact that they not only reduce the transmission of disease, they also provide a forum for addiction counselors to reach addicts that they would otherwise not see. Historically, many lawmakers have been opposed to such programs, arguing that they promote continued drug use; however, every lawmaker is aware that the opioid crisis in America has reached epidemic proportions and they are coming to see that they may have to think outside the box.

A Federal Ban On Needle Exchanges

Every day, needle exchanges operate throughout the country, but they do so without any financial support from the federal government. Needle exchange programs do a lot of good and with the spike of opioid addiction there is a much higher demand for clean needles – a reality which is spreading the programs thin.

In an attempt to assist such programs, last month Congress passed a measure that would lift a ban on funding needle exchanges, WBUR reports. While the measure’s passing could easily be considered to be a paradigm shift, the funding cannot be used for purchasing syringes – which can account for a third of the facilities overhead.

The funding can only be used for:

  • Staff
  • Vehicles
  • Counseling
  • Outreach

Baby Steps

It could easily be argued that the measure is lacking, but anything helps and we can only hope that this measure will be amended after Congress sees what the good needle exchange programs do for communities that have been hit hard by the opioid epidemic. Without expanded access to clean needles, the problem is only exacerbated.

“It is really an important and historic moment for us at syringe exchanges,” said Mark Casanova, Executive Director of Homeless Healthcare Los Angeles, which runs a syringe exchange. “But it doesn’t go far enough.”

Prescription Opioids: Who Should Be Held Accountable?

prescription opioidsWhen considering who is responsible for the prescription drug epidemic in America, it becomes difficult to determine where to point your finger. Some people blame doctors for rampant over prescribing, others would like to hold as accountable the pharmaceutical industry or the FDA for approving highly addictive prescription opioids for home use. The truth it seems is that there are a number of different entities which had a hand in creating the crisis we face today.

Naturally, some states have taken a harder hit than others, the byproduct of state laws which made it possible for people to gain greater access to powerful opioids, such as OxyContin (oxycodone). Data shows which states have had the highest opioid overdose rates. The Centers for Disease Control and Prevention (CDC) reports that West Virginia leads the nation in the rate of fatal drug overdoses. In the year 1999, which is often considered the time when the opioid problem began, the fatal overdose rate was 4.1 per 100,000 people. By 2010, West Virginia’s rate was 28.9 overdose deaths per 100,000, which was mainly attributed to prescription opioids. The staggering surge in opioid overdose deaths in the state has some lawmakers demanding accountability.

Wholesale Prescription Opioids?

The attorney general of West Virginia has filed a lawsuit against one of the nation’s largest prescription drug wholesalers, the Insurance Journal reports. Attorney General Patrick Morrisey has accused San Francisco-based McKesson Corporation of violating state consumer protection laws and the Uniform Controlled Substances Act.

The lawsuit claims that one of the major factors that contributed to West Virginia’s prescription drug abuse problem was McKesson Corp., which failed to detect, report and stop suspicious drug orders, according to the article. Between 2007 and 2012, McKesson distributed 99.5 million doses of hydrocodone and oxycodone to West Virginia.

“This failure is one cause of many for the state’s prescription drug overdose rate, decreased worker productivity and the wasteful expenditure of precious state resources,” Morrisey said.

Collective Responsibility/Collective Solutions

While, if the allegations are true, McKesson Corp. should share some of the costs of the problem the company had a hand in creating throughout the state, prescription drug distribution companies did not act alone. The industry itself needs to be held accountable and changes need to be made regarding the handling of pain management and how pharmaceutical companies are allowed to market.

“The flooding of prescription pills into our state is a very serious problem that involves all parts of the pharmaceutical supply channel,” said Morrisey. “No one group or industry sector is solely responsible for this problem; a solution must involve many actors, including doctors, pharmacies, wholesalers, manufacturers and government bodies.”

Monitoring the Future 2015

monitoring-the-futureEvery year, researchers at the University of Michigan conduct the Monitoring the Future (MTF) survey, funded by research grants from the National Institute on Drug Abuse (NIDA), one of the National Institutes of Health (NIH). The MTF is a long term epidemiological study that that looks at legal and illicit drug use and perceived risk of use among American adolescents and adults. The research has been ongoing since 1975. The MTF, among other things, provides experts with a window into people’s beliefs regarding drugs and alcohol use, allowing them to make informed decisions in the development of intervention techniques.

Monitoring the Future 2015

As the year comes to a close, we have a chance to see the progress we have made and the setbacks we have experienced as a nation. This year’s survey shows that overall; teens are reducing their use of:

  • Cigarettes
  • Alcohol (including binge drinking)
  • Prescription Opioids
  • Synthetic Marijuana

“These are some of the lowest numbers we have ever seen,” NIDA Director Dr. Nora D. Volkow told CBS News. “Notable is cigarette smoking — it is lower than we’ve ever seen it. Heroin is at the lowest it’s ever been. For prescription opiates, it’s the lowest we have ever seen. Overall this is very good news.”

Less Fire, More Smoke

While the aforementioned findings are promising, there is still work to be done – especially when it comes to marijuana. The researchers found that marijuana use has not declined among teenagers, CBS News reports. In fact, for the first time more high school seniors smoke marijuana than regular cigarettes on a daily basis.

In recent years, the nation has seen a growing tolerance for marijuana. Currently, there are 23 states and DC with medical marijuana programs, and four of the states have passed recreational use legalization for adults. The perceived dangers of marijuana use are fairly low among teenagers and young adults.

The researchers found that teens view marijuana as less risky this year, compared to last year, according to the report. Last year, 36.1 percent of 12th graders said that regular marijuana use could be harmful, compared to 31.9 percent this year.

Developing Brains

While marijuana use may not be as bad for the mind and body as, let’s say alcohol or heroin, marijuana use has been found to have negative effects on the brain – especially the developing brains of teenagers and young adults.

“Among teens, several studies provide evidence showing marijuana’s effects are deleterious,” said Volkow.

Cortisol May Curb Heroin Cravings

heroin-cravings, cortisolHeroin has been in the news a lot lately due to the number of overdose deaths occurring across the country. The rate of heroin use is staggering; many people find their way to the highly addictive substance by way of prescription opioids. Over the last few years, governmental measures intended to reduce prescription drug abuse has had the unintended consequence of nudging addicts towards heroin – which happens to be cheaper, stronger, and can easily lead to overdose.

Last year, 681,000 Americans aged 12 and older used heroin, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports. With over half a million users, the need for greater access to effective substance use disorder treatment is crucial. While drugs, such as buprenorphine, are effective at alleviating withdrawal symptoms and reducing cravings, addiction researchers are always looking for new methods that will give recovering addicts the best chance at a successful recovery.

Cortisol for Cravings

A new study has found that cortisol, a stress hormone, may reduce cravings for heroin, Newsweek reports. The research included 29 heroin addicts undergoing treatment with pharmaceutical heroin (diacetylmorphine). The researchers found that cortisol decreased cravings in heroin patients by up to 25 percent.

Cortisol is naturally secreted from the adrenal gland in response to stressful situations. Researchers at the University of Basel in Switzerland gave some patients cortisol tablets and others a placebo before administering a dose of heroin, according to the article. The patients were asked to rate their level of cravings at a later time.

The patients who were on a lower dose of heroin (up to 305 milligrams daily) and were given cortisol, reported having less craving for another dose of heroin. Unfortunately, patients who were taking a higher dose of heroin daily did not report having lower cravings.

The findings appear in Translational Psychiatry.

Looking Ahead

The study’s lead author, Dominique de Quervain, believes that cortisol may be helpful in treating other forms of addiction. More research is needed to determine the “safety and efficacy” of cortisol as a treatment for addiction.

“It might be interesting to see if [cortisol] also works for other addictions — for example, nicotine or gambling — because they are all driven by craving,” de Quervain said.

“We observed previously that cortisol can reduce memory retrieval in healthy subjects,” says de Quervain. “What we think is that cortisol, by reducing addiction memory, can actually also reduce craving.”

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If you are or loved one is addicted to opioids, please contact Next Step Intervention. We can assist you in finding the right treatment which will help you learn how to live a life free of opioids.

Surrender Your Drugs and Go To Treatment

surrender-drugsThe “war on drugs” has been quite effective with regard to getting addicts off the streets, but it has done little to address the problem of addiction – a disease which plagues millions of Americans. People who are arrested and imprisoned, simply for the crime of being an addict, often find themselves in a hamster wheel.

The rates of jail recidivism among drug addicts who are released is extremely high. Research tells us that jail does little when it comes to teaching people how to live a life free from drugs – something treatment does quite well.

Treatment Over Jail

In many states there exist drug courts, which give those charged with drug crimes the option of probation and addiction treatment counseling as opposed to being locked up. Such programs have been found to save taxpayers money, and help rather than harm a number of people who are already suffering. However, there are many who feel that treatment is more successful when it is not mandatory or forced.

In many states across the country, prescription drug abuse and heroin addiction have become the largest social welfare issue. The death toll related to the use of opioids is staggering and some cities have begun thinking outside the box.

Surrender Your Drugs and Go To Treatment

In the little New England city of Gloucester, Massachusetts, the local police chief launched a novel program which provides substance use disorder treatment for people who turn in their illegal drugs to the police, WBUR reports. Gloucester Police Chief Leonard Campanello said that 17 people have accepted the offer thus far.

While the number of people who have accepted treatment may seem small, Campanello points out that 17 people is more than three times the number of people who have died of drug overdoses in a town of 29,000, Needham, MA, this year alone. What’s more, the 17 who surrendered were using opioid drugs, such as heroin, morphine and oxycodone – drugs which all carry the potential for overdose.

“We need to get people into treatment,” Campanello said. “If they fail, we need to get them into treatment again. Just keep trying. Arresting them or coercing them into treatment just doesn’t work.”

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If you are struggling with prescription opioids or heroin abuse, please do not hesitate to contact Next Step Intervention. We can assist you in finding the right treatment which will help show you how to live a life free of opioid addiction.

DEA Crackdown On Prescription Opioid Narcotics

Operation-PillutedPeople in the United States consume the majority of prescription painkillers made worldwide, which has led to a prescription opioid epidemic. While efforts to curb the problem, such as prescription drug monitoring programs, have yielded some promising results, many addicts have turned to heroin, a cheaper and stronger alternative – creating a new problem. Nevertheless, the fight to end the prescription opioid crisis continues, and on Wednesday, the U.S. Drug Enforcement Administration (DEA) announced the results of a four-state prescription drug crackdown, Reuters reports.

The DEAs “Operation Pilluted,” set its sights on the illegal distribution of prescription opioid narcotics. The operation yielded 280 arrests, including:

  • 22 Doctors and Pharmacists
  • $404,828 in Cash Seized
  • 202 Weapons
  • 51 Vehicles

“DEA is committed to reducing the destruction brought on by the trafficking and abuse of prescription drugs through aggressive criminal enforcement, robust administrative oversight, and strong relationships with other law enforcement agencies, the public, and the medical community,” said DEA Special Agent in Charge Keith Brown in a statement. “The doctors and pharmacists arrested in Operation Pilluted are nothing more than drug traffickers who prey on the addiction of others while abandoning the Hippocratic Oath adhered to faithfully by thousands of doctors and pharmacists each day across this country.”

Over the course of 15 months, agents involved in Operation Pilluted, observed and arrested people on federal and state criminal charges, according to the article. The operation was headed up by the DEA’s New Orleans Field Division, which resulted in the arrests of individuals in Louisiana, Arkansas, Alabama and Mississippi.

The south, arguably, has been hit the hardest by the prescription drug epidemic. Federal and state officials have been working tirelessly over the last several years to implement prescription drug monitoring programs aimed at doctor shoppers, and to shut down pill mills which were flooding the streets with powerful narcotics. Prescription drug companies have been urged to create abuse-resistant pain medications, drugs that make it more difficult for abusers to tamper with the medications.

The DEA called Operation Pilluted its largest-ever prescription drug operation.

If you are struggling with prescription opioids do not hesitate to call for help.

Learning From WILD The Movie And A Walk Through Opioid History

Schematic overview of course and lands of the ...
Schematic overview of course and lands of the Pacific Crest Trail (Photo credit: Wikipedia)

“What if I forgave myself? I thought. What if I forgave myself even though I’d done something I shouldn’t have? What if I was a liar and a cheat and there was no excuse for what I’d done other than because it was what I wanted and needed to do? What if I was sorry, but if I could go back in time I wouldn’t do anything differently than I had done? What if I’d actually wanted to f–k every one of those men? What if heroin taught me something? What if yes was the right answer instead of no? What if what made me do all those things everyone thought I shouldn’t have done was what also had got me here? What if I was never redeemed? What if I already was?”
Cheryl Strayed, Wild: From Lost to Found on the Pacific Crest Trail

 

Cheryl Strayed sought to reinvent herself by walking 1100 miles

If you haven’t read Cheryl Strayed’s Wild: From Lost to Found on the Pacific Crest Trail or seen the recently released WILD starring Reese Witherspoon as Cheryl Strayed, then you might want to check out either the book or the movie. This past week one of our associates saw the movie and reported that she knew nothing about the book and had only seen previews of the movie. Basically she, like Cheryl, had no idea what she was getting herself into.

If you are having trouble viewing the video, you can see it here.

Anyone who has ever hiked any part of the Pacific Crest Trail knows what Cheryl was up against, but if you add to the strenuous nature of the trail, unpredictable weather and a woman who’s seeking to “get well” after living through what many have described as a four year bender, then you might come to the conclusion that Cheryl’s memoir is about her intervening in the journey she found herself on after losing her mother to cancer.

Cheryl took a walk on the WILD side…or as one reviewer said she was on an emotional odyssey.

While we learn from movies, we also continue to learn from history

Watching WILD the viewer gets just a glimpse of what opioid use and abuse can dissolve into…heroin addiction. You can read multiple news articles every day how different states, cities, towns, schools of all levels, businesses and families are trying to cope with painkiller abuse. It is often referred to as an epidemic.

The odd thing about all of this is that as a society we seem truly surprised to find ourselves engaged in this battle and with such intensity. Over the holidays we read an article in The New York Times, Painkiller Abuse, a Cyclical Challenge. We hope you will take the time to read the article, it offers some powerful photographs and a timeline that is worth noting.

The author Austin Frakt wants his readers to understand that this is not a new epidemic, but the latest in the cycle. As a society, at least since the late 19th century we have attempted to develop social policy that will deal with the latest onset.

  • In the late 1800s opioid products were not regulated. Heroin was created by Bayer Pharmaceuticals to be used for coughs.
  • In 1906 the Pure Food and Drug Act was passed and required drug labels to include all of the ingredients to be listed.
  • The 1914 Harrison Narcotics Tax Act took effect with a goal to curb use, by taxing narcotics. Additionally, it was decided with this act that it would be permissible to use opioids to treat pain, but not as part of a maintenance program for addiction.
  • By the 1920s heroin was frequently prescribed for menstrual pain.
  • In 1925 the Supreme Court legalized opioids to be used as maintenance treatment for addiction.
  • In 1935 the Federal Medical Center, located in Lexington, KY, opened. It was dedicated to treat substance use disorders. (It is also known for conducting addiction research and experiments.)
  • Jump ahead to the 1950s with a growing number of overdose deaths as a result of opioid use.
  • In 1961 the United Nations’ declaration that access to pain medication was a human right opened the door to more use and addiction.
  • By 1966 some states and then the federal government enacted laws that would allow addicts to be hospitalized on an involuntary basis.
  • In 1970 the Controlled Substance Act was passed by the 91st Congress and signed into law by President Nixon. The DEA was established. Both actions were supported by a number of intervention studies which pointed to the efficacy of treatment for addiction, including methadone type substances.
  • Of late, the federal government and 49 states have built databases to help control the sale and use of opioids. Such programs track the prescribers and the users of these drugs.
  • Naloxone is being promoted to have available in schools, homes and with first responders to react quickly to save a person who has overdosed.

As we move into the New Year…

It is true…it is important to remember history and to take the time to study history. This applies to family history as well. It is vital to understand that addiction is a family disease. With this understanding spouses and parents should stay alert to signs. If your loved one’s behavior has been slowly changing, ask questions. Are they late for work, do they oversleep, are grades changing, are they dropping off of sports teams, is their circle of friends changing, are they losing weight…the signs are there. Pay attention.

If you need help in starting the conversation, feel free to call us.  Recovery is possible.

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